Individual provider Active NPI

Emily J Heinrich, OD

  • Optometrist
  • Fargo, ND
National Provider Identifier
1982591079
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
831 Issued in ND
Practice address
2601 University Dr S
Fargo, ND 58103-6025
Phone
(701) 235-5200
NPI assigned
Jun 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 831 ND Primary

Addresses

Primary practice location

2601 University Dr S
Fargo, ND 58103-6025

Mailing address

5835 Autumn Dr S
Fargo, ND 58104-7654
Phone (701) 261-1718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250717001719 ND Practitioner - Optometry 5698280659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lance K Bergstrom MD PCGroup PAC ID 3577542216, 3 clinicians

Practice addresses (Care Compare)

2601 University Dr S
Fargo, ND 58103-6025
Phone (701) 235-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
831NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lance K Bergstrom MD, PC Optometrist CurrentSince Jul 1, 2025 Accepting new patients
Steven B Thom, MD PC PastSince Jun 23, 2025 Accepting new patients

Locations

2601 University Dr S
Fargo, ND 58103
Phone (701) 235-5200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1982591079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5835 AUTUMN DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047654",
            "telephone_number": "701-261-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036025",
            "telephone_number": "701-235-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINRICH",
        "first_name": "EMILY",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.